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Quality indicator endoscopy

Mery Munoz-Persy, Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a unique form of non-IgE-mediated food allergy characterized by esophageal eosinophilic infiltration that commonly causes dysphagia and food impaction in children and adolescents. Assessing the efficacy of dietary restrictions or drug therapies to achieve clinical and histologic resolution of EoE through randomized controlled trials and meta-analyses has resulted in new evidence-based guidelines. Avoiding food triggers is the only therapy targeting the cause of the disease...
March 17, 2018: European Journal of Pediatrics
Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
Peter M Irving, Tariq Iqbal, Chuka Nwokolo, Sreedhar Subramanian, Stuart Bloom, Neeraj Prasad, Ailsa Hart, Charles Murray, James O Lindsay, Adam Taylor, Rachel Barron, Stephen Wright
Background: Cannabidiol (CBD) exhibits anti-inflammatory properties that could improve disease activity in inflammatory bowel disease. This proof-of-concept study assessed efficacy, safety and tolerability of CBD-rich botanical extract in ulcerative colitis (UC) patients. Methods: Patients aged 18 years or older, with left-sided or extensive UC, Mayo scores of 4-10 (endoscopy scores ≥1), and on stable 5-aminosalicylic acid dosing, were randomized to 10-weeks' CBD-rich botanical extract or placebo capsules...
March 10, 2018: Inflammatory Bowel Diseases
Way-Seah Lee, Chun-Wei Tee, Zhong-Lin Koay, Tat-Seng Wong, Fatimah Zahraq, Hee-Wei Foo, Sik-Yong Ong, Shin-Yee Wong, Ruey-Terng Ng
AIM: To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center. METHODS: We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years (January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks...
March 7, 2018: World Journal of Gastroenterology: WJG
Christopher D Mills, Chere McCamley, Michael P Swan
GOALS: To determine the effect of carbon dioxide insufflation on the most important outcome measure of colonoscopic quality: adenoma detection rate (ADR). BACKGROUND: Bowel cancer is the second most common cause of cancer deaths in males and females in Australia. Carbon dioxide has in recent times become the insufflation methodology of choice for screening colonoscopy for bowel cancer, as this has been shown to have significant advantages when compared with traditional air insufflation...
March 7, 2018: Journal of Clinical Gastroenterology
William Syrmis, Russell Richard, Sue Jenkins-Marsh, Siew C Chia, Phillip Good
BACKGROUND: Malignant bowel obstruction (MBO) is a common problem in patients with intra-abdominal cancer. Oral water soluble contrast (OWSC) has been shown to be useful in the management of adhesive small bowel obstruction in identifying patients who will recover with conservative management alone and also in reducing the length of hospital stay. It is not clear whether the benefits of OWSC in adhesive small bowel obstruction are also seen in patients with MBO. OBJECTIVES: To determine the reliability of OWSC media and follow-up abdominal radiographs in predicting the success of conservative treatment in resolving inoperable MBO with conservative management...
March 7, 2018: Cochrane Database of Systematic Reviews
Roberto L Kaiser Junior, Luiz G de Quadros, Mikaell A G Faria, Fernanda S L Kaiser, Juan C O Campo, Idiberto J Zotarelli Filho
Background: Colonoscopy procedures are commonly performed and have high success rates. However, poor or inadequate bowel preparation is one of the most common reasons for a repeated or failed colonoscopy. We therefore performed an observational study followed by propensity score modeling to evaluate and compare the quality of bowel preparation with the use of Aquanet bowel cleansing devices (BCDs) versus the use of oral sodium picosulfate solution. Methods: We performed a prospective cross-sectional study to compare the quality of pre-endoscopic bowel preparation using a BCD with oral solution...
February 2018: Gastroenterology Research
Dragoş Predescu, Silviu Constantinoiu
Background: A few decades ago, esophageal substitution was mainly dedicated particularly in postcaustic esophageal stenosis; currently, the reconstruction has expanded its palette of indications to other areas of benign esophageal pathology (severe motor disorders, esophageal achalasia with multiple relapses, peptic stenosis, etc.) but has also become a quasi-obligatory final time in the esophagectomy for cancer whenever it is possible. The techniques of esophageal reconstruction using the stomach, regardless of the indication and the chosen technical option, remain a valuable and effective method...
January 2018: Chirurgia
Arianna Barbetta, Shahdabul Faraz, Pari Shah, Hans Gerdes, Meier Hsu, Kay See Tan, Tamar Nobel, Manjit S Bains, Matthew Bott, James M Isbell, David B Sewell, David R Jones, Daniela Molena
BACKGROUNDS AND AIMS: As treatment for esophageal cancer often involves a multidisciplinary approach, the initial endoscopic report is essential for communication between providers. Several guidelines have been established to standardize endoscopic reporting. This study evaluates the compliance of esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS) reporting with the current national guidelines. METHODS: Combining the National Comprehensive Cancer Network and Society of Thoracic Surgeons guidelines, 11 quality indicators (QIs) for EGD and 8 for EUS were identified...
March 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Stacy Bartnik Menees, H Myra Kim, Philip Schoenfeld
AIM: To quantify the impact of split-dose regimen on endoscopists' compliance with guideline recommendations for timing of repeat colonoscopy in patients with normal colonoscopy or 1-2 small polyps (< 10 mm). METHODS: A retrospective chart review of all endoscopy reports was undertaken in average-risk individuals > 50 years old with a normal screening colonoscopy and 1-2 small polyps. Data were abstracted from two time periods, pre and post-split-dose bowel preparation institution...
February 14, 2018: World Journal of Gastroenterology: WJG
Nicholas J Shaheen, M Brian Fennerty, Jacques J Bergman
A substantial literature documents inappropriate usage of gastrointestinal endoscopy in a variety of clinical settings. Overusage of endoscopy appears to be common, and 30% or more of procedures performed in some clinical settings have questionable indications. The potential reasons for overuse of endoscopy are multiple, and include cancer phobia, fear of medical malpractice litigation, profit motive, the investigation of "incidentalomas" found on other imaging, and under-appreciation of the delayed harms of endoscopy, among other reasons...
February 15, 2018: Gastroenterology
Øyvind Holme, Ina Borgenheim Pedersen, Asle W Medhus, Lars Aabakken, Tom Glomsaker, Jan Magnus Kvamme, Magnus Løberg, Michael Bretthauer, Birgitte Seip, Øystein Kjellevold, Anita Jørgensen, Siv Furholm, Geir Hoff, Thomas de Lange
BACKGROUND:  Colonoscopy performance varies between endoscopists, but little is known about the impact of endoscopy assistants on key performance indicators. We used a large prospective colonoscopy quality database to perform an exploratory study to evaluate differences in selected quality indicators between endoscopy assistants. METHODS:  All colonoscopies reported to the Norwegian colonoscopy quality assurance register Gastronet can be used to trace individual endoscopy assistants...
February 14, 2018: Endoscopy
Petra Decristoforo, Josef Kaltseis, Andreas Fritz, Michael Edlinger, Wilfried Posch, Doris Wilflingseder, Cornelia Lass-Flörl, Dorothea Orth-Höller
OBJECTIVES: Several outbreaks of severe infections due to contamination of gastrointestinal (GI) endoscopes, mainly duodenoscopes have been described previously. The rate of microbial endoscope contamination is varying dramatically in literature. Thus, the aim of this multicentre prospective study was to evaluate the hygiene quality of endoscopes and automated endoscope reprocessors (AERs) in Tyrol/Austria. METHODS: In 2015 and 2016, a total of 463 GI endoscopes and 105 AERs from 29 endoscopy centres were analysed by a routine (R) and a combined routine and advanced (CRA) sampling procedure and investigated for microbial contamination by culture- and molecular-based analyses...
February 2, 2018: Clinical Microbiology and Infection
Sofia Xavier, Sara Monteiro, Joana Magalhães, Bruno Rosa, Maria João Moreira, José Cotter
AIM: To compare the findings and completion rate of PillCam® SB2 and SB3. METHODS: This was a retrospective single-center study that included 357 consecutive small bowel capsule endoscopies (SBCE), 173 SB2 and 184 SB3. The data collected included age, gender, capsule type (PillCam® SB2 or SB3), quality of bowel preparation, completion of the examination, gastric and small bowel transit time, small bowel findings, findings in segments other than the small bowel and the detection of specific anatomical markers, such as the Z line and papilla...
December 26, 2017: Revista Española de Enfermedades Digestivas
Felicia Humphrey, Mariella Gastañaduy, James Smith, Charles B Whitlow
Background: An interval colorectal cancer is a cancer diagnosed prior to the recommended follow-up time from a previously negative colonoscopy. These cancers are thought to arise from a rapidly growing cancer, missed cancer, or incompletely resected adenomas. Our study aimed to identify interval cancers diagnosed during a 4-year period and to identify any potential risk factors associated with these cancers. Secondly, we compared our interval colorectal cancer rate with other published rates...
2017: Ochsner Journal
S P Maharaj, M A Noorbhai, T E Madiba
BACKGROUND: The Minimal Standard Terminology (MST) was developed to standardise endoscopic reporting. This study is aimed at assessing current reporting at a tertiary hospital and whether it meets this Minimal Standard Terminology. METHOD: This was a retrospective observational study of upper endoscopy reports between January and December 2014. The data extracted were compared to the current reporting standard listed in the MST. To assess and grade the quality of reporting we developed a Gastrointestinal Reporting Score, which incorporates MST variables in addition to demographic details, indication for endoscopy, report legibility, sedation and the use of classification systems to describe pathology...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Judy A Corliss
Although colon cancer is preventable, it is still the second leading cause of cancer death in both men and women in the United States (). Colonoscopy is as yet the gold standard for colon cancer prevention (). The success of colonoscopy is dependent upon the quality of the bowel prep. The problem addressed in this study was the impact of hospitalization on bowel prep quality. The participants in this study were 54 consecutive inpatients older than 18 years and 52 consecutive outpatients older than 18 years who were scheduled for colonoscopy in the Endoscopy Lab at Santa Barbara Cottage Hospital...
November 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
Taylan Kav
Gastroesophageal reflux disease (GERD) is a chronic disease characterized with heartburn and regurgitation symptoms. The prevalence of these symptoms in Turkey is reported to be as high as 20%. GERD negatively effects the quality of life along with the development of some complications due to chronic course. Upper gastrointestinal endoscopy is commonly performed for diagnosis and surveillance of complications in the context of GERD. However, there is no consensus in terms of timing and indications for endoscopy, use of esophagitis classification system, to obtain a biopsy sample or recommendation for surveillance endoscopy...
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Lorant Gonczi, Zsuzsanna Kurti, Petra Anna Golovics, Barbara Dorottya Lovasz, Orsolya Menyhart, Anna Seres, Liza Dalma Sumegi, Alexander Gal, Akos Ilias, Papp Janos, Krisztina Barbara Gecse, Talat Bessisow, Waqqas Afif, Alain Bitton, Zsuzsanna Vegh, Peter Laszlo Lakatos
BACKGROUND: In the management of inflammatory bowel diseases, there is considerable variation in quality of care. AIMS: The aim of this study was to evaluate structural, access/process components and outcome quality indicators in our tertiary referral IBD center. METHODS: In the first phase, structural/process components were assessed, followed by the second phase of formal evaluation of access and management on a set of consecutive IBD patients with and without active disease (248CD/125UC patients, median age 35/39 years)...
October 9, 2017: Digestive and Liver Disease
Marijn J Warners, Pieter Hindryckx, Barrett G Levesque, Claire E Parker, Lisa M Shackelton, Reena Khanna, William J Sandborn, Geert R D'Haens, Brian G Feagan, Albert J Bredenoord, Vipul Jairath
OBJECTIVES: There is no clear consensus regarding the most appropriate measure(s) of eosinophilic esophagitis (EoE) disease activity. We aimed to identify all scoring indices used for the measurement of disease activity in EoE, appraise their operating properties, and discuss their value as outcome measures. METHODS: MEDLINE, EMBASE, and CENTRAL (The Cochrane library) were searched from inception to 11 May 2016. Randomized controlled trials (RCTs), cohort, case-control, and cross-sectional studies that reported outcomes to measure EoE disease activity or response to treatment were eligible...
November 2017: American Journal of Gastroenterology
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